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Journal of the American College of Nutrition Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/uacn20
Glycemic index of traditional Indian carbohydrate foods. a
a
a
a
a
U V Mani , S Bhatt , N C Mehta , S N Pradhan , V Shah & I Mani
a
a
Department of Foods and Nutrition, Medical College, MS University of Baroda, Gujarat State, India. Published online: 02 Sep 2013.
To cite this article: U V Mani, S Bhatt, N C Mehta, S N Pradhan, V Shah & I Mani (1990) Glycemic index of traditional Indian carbohydrate foods., Journal of the American College of Nutrition, 9:6, 573-577, DOI: 10.1080/07315724.1990.10720411 To link to this article: http://dx.doi.org/10.1080/07315724.1990.10720411
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions
Glycémie Index of Traditional Indian Carbohydrate Foods Uliyar V. Mani, PhD, Siriita Bhatt, MSc, Nivedita C. Mehta, MD, Smruti N. Pradhan, MSc, Viren Shah, MD, and Indirani Mani, PhD Department of Foods and Nutrition (U. V. M.) and Department of Medicine (N. C. M.), Medical College, MS University of Baroda, Gujarat State, India Key words: glycémie index, diabetes mellitus, conventional meals
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The glycémie index (GI) was determined in 36 non-insulin-dependent diabetes mellitus patients who were fed 50 g carbohydrate portions of six Indian conventional foods, including rice, a combination ofrice—legume(Bengalgram, peas, and greengram), and a combination of rice-dal (greengram dal and redgram dal — dal is dehusked and split legume). In addition to the GI, triglycéride (TG) responses of these foods were also determined. A higher GI was obtained for rice and for rice with peas; all other combinations yielded lower glycémie indices. However, all the foods produced significantly lower blood glucose response 2 hours postprandially as compared with blood glucose responses to a 50 g glucose load for the same group. No significant difference was observed for TG responses to the different foods.
INTRODUCTION Dietary modification is the most important part of the management of non-insulin-dependent diabetes mellitus (NIDDM), in which the primary derangement is of car bohydrate metabolism, with secondary abnormalities of lipid and protein metabolism. It has been found that the same weight of carbohydrate in different foods can produce widely different blood glucose responses. The concept of glycémie index (GI) was introduced as a physiological basis for carbohydrate exchange [1] and is important in determining glycémie responses of mixed meals versus individual foods. The nutrition committees of American and Canadian diabetes associations recom mend that diets for diabetics be planned with the GI of foods in mind [2,3]. Information regarding the GI of conventional Indian foods is scanty, except for foods evaluated by Dilawari et al [4] and Akhtar et al [5], who studied the glycémie responses to cereals and a few legumes and dais (dais are dehusked and split legumes). Hence, the present study was planned to determine the GI of six cereal-legume/dal combinations that are im portant in the diet of this region of India. Hyperglycemia brings about disturbances in lipid metabolism in diabetes and enhances secondary complications. Hence, foods recommended in diabetes should also have low lipemic
responses. In this study, we also report the postprandial triglycéride (TG) responses of the recipes along with postprandial sugar levels.
METHODS AND MATERIALS Thirty-six confirmed non-insulin-dependent diabetes mellitus (NIDDM) patients over 40 years of age on oral hypoglycémie drugs were selected for testing the glycémie response of the recipes. The clinical data for the subjects are given in Table 1. On the first visit, an oral glucose tolerance test (GTT) was done for all patients using 50 g glucose. Blood glucose was deter mined by the o-toluidine method [6] in fasting and postprandial (1- and 2-hr) samples; TG was determined in fasting and 2-hr postprandial blood samples [7]. The patients were divided into six groups, each group con sisting of six patients. On subsequent visits (within 2 weeks), the patients were given a test food containing 50 g carbohydrate which was consumed over 8-10 minutes. The composition of the foods as determined by food tables [8] is given in Table 2. Again, blood glucose and TGs were determined for the different groups fed different foods. GTT curves and glycémie response curves for the foods were plotted and GI was calculated
Addressreprintrequeststo Dr. Uliyar V. Mani, Department of Foods and Nutrition, MS University of Baroda, Baroda 390 002, Gujarat State, India
Journal of the American College of Nutrition, Vol. 9, No. 6, 573-577 (1990) © 1990 John Wiley & Sons, Inc.
CCC 0731-5724/90/060573-05$04.00
Glycémie Index of Various Meals Table 1. Clinical Data
Number of diabetic patients Mean age ± SD (years) Mean % ideal body weight ± SD (kg) Mean duration of disease ± SD (years)
Male
Female
17
19
52.8 ± 8.00
56.2 ± 6.50
12.21 ± 13.89
123.84 + 24.70
2.50 ±1.00
3.90 ± 0.60
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Table 2. Composition of Foods
Recipes Rice alone R,
Rice and legume R2
R3
R4
Food items
Botan ical name
Raw wt(g)
Energy Carbo Protein (kcal) hydrate (g) (g)
Fat (g)
Crude fiber (g)
Rice (milled, white rice)
Oryza sativa
64
221
50
4.4
0.3
0.13
Rice (milled) +Bengalgrama (chick peas) Rice (mUled) +Dried green peas" Rice (mUled) +Greengram (whole)3
Oryza sativa Cicer arietinum
45
155
35
3.1
0.2
0.089
25
90
15
4.3
1.3
0.98
Oryza sativa Pi sum sativum
45
155
35
3.1
0.2
0.089
27
85
15
5.3
0.3
1.21
Oryza sativa Phaseolus aureus
45
155
35
3.1
0.2
0.089
26
87
15
6.2
0.3
1.06
Oryza sativa Phaseolus aureus Oryza sativa Cajanus cajan
45
155
35
3.1
0.2
0.089
25
87
15
6.1
0.3
0.20
45
155
35
3.1
0.2
0.089
26
87
15
5.8
0.4
0.39
5
45
-
-
5.0
-
Rice and dal b Rs
Re
AU
Rice (milled) +Greengram dal Rice (milled) +Redgram dal (pigeon pea) Oil
a
The legumes were presoaked overnight for 12 hours and then cooked along with rice. Dal is dehusked and split legume.
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Table 3. Glycémie Index of the Foods Number Ri
R2 R3 R4 R5 *6
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a
Glycémie index (mean ± SE)
Recipe Rice (milled, white) Rice + Bengalgram (chick pea) Rice + peas (dried, green) Rice + greengram (whole) Rice + greengram dal Rice + redgram dal (pigeon pea)
74±8 a 54±lb 80 ±14 68 ±18 62 ± 8 64±6
' Significant at p < 0.05 level on comparison of a with b.
using the method described by Jenkins et al [1] by deter mining the ratio of the areas under the glucose response curve for the food, compared with that of the GTT. The TG response was calculated by finding the percent in crease in mean TG value over mean fasting value for six patients. The six foods given were: rice alone (R,); rice-Bengalgram (chick pea) (R2); rice-peas (dried green) (R3); rice-greengram (R4); rice-greengram dal (dehusked and split whole greengram) (R5); rice-redgram dal (dehusked and split whole pigeon pea) (R6). The foods were pres sure-cooked at 15 lb pressure for 15.5 minutes using 385 ml of water. The legumes (Bengalgram, peas, and greengram) were soaked overnight for 12 hours and then cooked with the rice. The glucose value after each test food and after the glucose load, was statistically compared using a paired t-test. Student's t-test for unpaired data was used to com pare glucose values among the test foods.
RESULTS The GI values obtained for the foods are given in Table 3. With the exception of R, and R2, there is no significant difference between mean GI values of the foods used. Table 4 presents the mean value ± SEM of blood glucose to a 50 g glucose load as well as the respective foods. There was a significantly lower blood glucose response after each of the foods at 2 hours postprandially when compared with the corresponding blood glucose response to the 50 g glucose load for the same group. One hour postprandially there were sig nificantly lower responses to R2, R3, R4, and R6 than to a 50 g glucose load for the same group, and the mean values of the remaining two foods were not significantly different from the response to glucose.
Table 5 presents the 2-hr postprandial TG response. No significant differences were observed for TG response among the foods.
DISCUSSION The concept of the GI of various foods has emerged as a boon to dietary therapy for diabetes mellitus, in dicating the beneficial aspect of foods consumed both individually and as mixed meals. Thus, GI results demonstrate differences in carbohydrate elevation of blood glucose levels, which is useful in planning diabetic diets. The differences observed in GI are attributable to the structure of starch granules, amylose and amylopectin content, protein and fat content, and the method of processing and preparation [9]. These observations have led to an analysis of foods consumed by populations of different countries for food habits and methods of preparation that vary greatly. Presented here is an exten sion of the studies by Dilawari et al [4] of glycémie responses to foods consumed in India and by Akhtar et al [5] of common Pakistani dishes. We have determined the GI for the most commonly used single foods and mixed meals in the region of Baroda (India) by determining glucose responses at two time intervals. Starch granules in cereal grains are structurally dif ferent from those in leguminous seeds. This affects par ticle size and surface area, resulting in altered digestion by hydrolytic enzymes. Rice starch granules are small and angular, probably resulting in a higher GI, as ob served for the GI of the foods tested in this study. Fur ther, the ratio of amylose to amylopectin content, as well as the amylopectin branching pattern, affects the physi cal characteristics of starch, both with regard to its cook ing quality and digestibility [10]. Legumes and dais have a higher amylose content (30-40%), which is more resis-
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Glycémie Index of Various Meals Table 4. Mean (+SE) Blood Glucose Responses (mg/dl) (n = 6) Postprandial responses
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Carbohydrate source
Fasting responses
1 hour
Glucose R[ — Rice alone
162 ± 12» 150±17 b
298 ± 23.03 260 ± 26.25
261 ±21.24 226 ± 20.44*
Glucose R2 — Rice + Bengalgram (chick pea)
169 ± 22» 152 ± 27b
329 ± 36 225 ± 30*
260 ± 32 189 ± 26*
Glucose R3 — Rice + dried green pea
140 ±25» 135 ± 24b
252 ±32 215 ± 29*
207 ± 37 183 ± 28*
Glucose R4 — Rice + greengram (whole)
148 ± 17» 125 ± 9 b
274 ±26 208 ± 34*
232 ± 21 170 ±23*
Glucose R5 — Rice + greengram dal
150 ±9» 137 ± 15b
282 ± 28 219 ±22
225 ± 21 179 ± 20*
Glucose R6 — Rice + redgram dal
194 ±21» 180±22 b
333 ± 28 271 ±25*
281 ±22 223 ± 22*
2 hours
♦Significantly lower response than glucose at p < 0.05. Nonsignificant on comparing a with b at p < 0.05.
Table 5. Mean (+SE) Triglycéride Responses (mg/dl) Fasting responses
2-hour postprandial responses
% increase over fasting
Glucose R, — Rice milled
132 ± 47 100 ±16
204 ±74 140 ± 18
40
Glucose R2 — Rice + Bengalgram (chick pea)
112 ±34 104 ±17
119 ±42 134 ± 22
28
Glucose R3 — Rice + dried green peas
97 ±36 104±21
107 ±44 125 ± 16
20
64 ±13 90 ±22
64 ±16 135 ±13
50
169 ± 25 152 ±15
221 ±46 164 ±40
8
62 ± 7 86 ± 8
79 ±18 120 ±13
39
Carbohydrate source
Glucose R4 — Rice + greengram (whole) Glucose R5 — Rice + greengram dal Glucose R6 — Rice + redgram dal (pigeon pea)
tant to cooking and digestion than amylopectin. Rice has a higher amylopectin content, which may partially ex plain the higher GI of rice. Dietary fiber, due to its viscous nature, inhibits starch digestion and/or absorption. Fiber and galactomannans that are present in legumes and dais (dehusked and split legume) are more viscous than those found in cereals [11]. The higher fiber content of legumes than of dais is responsible for their lower GI, as seen for R, and R2
576
(p < 0.05). The differences among the foods tested sug gest that addition of Bengalgram (and possibly other legumes) to rice reduces the glycémie response. In spite of the fiber content being high in R3, the GI was found to be slightly higher than that of R,. This might be due to the higher glycémie response to peas, an observation ear lier recorded by Wolever et al [12] and Jenkins et al [13]. Besides dietary fiber, phytic acid lectins, saponins, tannins, and amylase inhibitors affect starch digestibility
VOL. 9, NO. 6
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Glycémie Index of Various Meals and might be correlated negatively with glycémie response. Further experiments are required to determine the influence of such substances on the GI of foods. The method of cooking and preparation also affect starch digestion and hence glycémie response [14]. Cooking (gelatinization) disrupts the starch granule so that it is hydrolyzed in the intestine. In general, highamylose starch granules are less easily disrupted and are more slowly hydrolyzed by digestive enzymes. Thus, the higher GI of rice observed in this study may be attributed to its higher amylopectin content and possibly to over cooking with the heat in a pressure cooker [15]. The foods evaluated in this study were similarly prepared. Since diabetes meilitus causes not only abnormal car bohydrate metabolism but also alters lipid metabolism, especially cholesterol and TG [16,17], we also deter mined TG responses to the foods. The TG responses do not correlate with their fat content and were statistically nonsignificant. The TG responses did not correlate with GI responses. Further study with a larger sample size is necessary to verify these preliminary findings. For NIDDM patients, foods that evoke low TG responses may have value in the dietary management of diabetes meilitus. Since several factors in foods affect glycémie and TG responses, prediction of response on the basis of chemi cal analysis is difficult. Hence, much research is required to evaluate the relative merits of classifying foods ac cording to GI versus the exchange system used at present in planning diabetic diets.
ACKNOWLEDGMENTS The authors express their grateful thanks to Professor D. J. A. Jenkins and Professor T. M. S. Wolever of the Department of Nutritional Sciences at the University of Toronto (Canada) for their valuable criticisms and sug gestions in the preparation of this manuscript.
REFERENCES 1. Jenkins DJA, Wolever TMS, Taylor RH: Glycémie index of foods: a physiological basis of carbohydrate exchange. Am J Clin Nutr 34:362-367, 1981.
2. American Diabetes Association: Policy statement: glycémie effects of carbohydrate. Diabetes Care 7:607608, 1984. 3. Special Report Committee, Canadian Diabetes Associa tion: Guidelines for the nutritional management of Diabetes Meilitus. J Can Diet Assoc 42:110-118,1981. 4. Dilawari JB, Kamat PS, Batta RP, Mukewar S, Raghavan S: Reduction of postprandial plasma glucose by Ben galgram dal (Cicer arietinum) and Rajmah (Phaseolus vulgaris). Am J Clin Nutr 34:2450-2353, 1981. 5. Akhtar MS, Asim AH, Wolever TMS: Blood glucose responses to traditional Pakistani dishes taken by normal and diabetic subjects. Nutr Res 7:696-706, 1987. 6. Council for Scientific and Industrial Research: Diagnostic kit for blood glucose, method of Hultman E. Nature (Lon don) 183:108-109, 1959. 7. Foster LB, Dunn RJ: Stable reagent for determination of serum triglycérides by a calorimetrie Hantzsh condensa tion method. Clin Chem 19:338-340, 1973. 8. Gopalan C, Ramashastri BV, Balasubramaniam SC: Proximate principles, minerals, and vitamins. In National Institute of Nutrition (ed): "Nutritive Values of Foods." Hyderabad: Citizen Press, pp 60-115, 1979. 9. Jenkins DJA, Jenkins AL, Wolever TMS: Simple and complex carbohydrates. Nutr Rev 44(2):44-48, 1986. 10. Behall KM, Scholfield DJ, Canary J: Effect of starch structure on glucose and insulin responses in adults. Am J Clin Nutr 47:428-432, 1988. 11. Jenkins DJA, Wolever TMS, Leeds AR: Dietary fibres, fibre analogues and glucose tolerance: importance of vis cosity. Br Med J 1:392-394,1978. 12. Wolever TMS, Csima A, Jenkins DJA, Wong GS, Josse RG: The glycémie index: variation between subjects and predictive difference. J Am Coll Nutr 8:235-247, 1989. 13. Jenkins DJA, Wolever TMS, Taylor RH, Barker HM, Fielden H: Exceptionally low blood glucoseresponsesto dried beans: comparison with other carbohydrate foods. Br Med J 281:578-580, 1980. 14. Gannon MC, Nuttall FQ: Factors affecting interpretation of postprandial glucose and insulin areas. Diabetes Care 10:759-763, 1987. 15. Krezowski DA, Nuttall FQ, Gannon MC: Insulin and glucose responses to various starch-containing foods in type II diabetic subjects. Diabetes Care 10:205-211,1987. 16. Cerami A, Vlassara H, Brownlee M: Glucose and aging. Sei Am 256:90-97,1987. 17. Reaven GM: Abnormal lipoprotein metabolism in non-in sulin-dependent diabetes meilitus: pathogenesis and treat ment. Am J Med 83:31-39, 1987. ReceivedNovember 1988; revision accepted April 1990.
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Journal of the American College of Nutrition Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/uacn20
Glycemic index of traditional Indian carbohydrate foods. a
a
a
a
a
U V Mani , S Bhatt , N C Mehta , S N Pradhan , V Shah & I Mani
a
a
Department of Foods and Nutrition, Medical College, MS University of Baroda, Gujarat State, India. Published online: 02 Sep 2013.
To cite this article: U V Mani, S Bhatt, N C Mehta, S N Pradhan, V Shah & I Mani (1990) Glycemic index of traditional Indian carbohydrate foods., Journal of the American College of Nutrition, 9:6, 573-577, DOI: 10.1080/07315724.1990.10720411 To link to this article: http://dx.doi.org/10.1080/07315724.1990.10720411
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions
Glycémie Index of Traditional Indian Carbohydrate Foods Uliyar V. Mani, PhD, Siriita Bhatt, MSc, Nivedita C. Mehta, MD, Smruti N. Pradhan, MSc, Viren Shah, MD, and Indirani Mani, PhD Department of Foods and Nutrition (U. V. M.) and Department of Medicine (N. C. M.), Medical College, MS University of Baroda, Gujarat State, India Key words: glycémie index, diabetes mellitus, conventional meals
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The glycémie index (GI) was determined in 36 non-insulin-dependent diabetes mellitus patients who were fed 50 g carbohydrate portions of six Indian conventional foods, including rice, a combination ofrice—legume(Bengalgram, peas, and greengram), and a combination of rice-dal (greengram dal and redgram dal — dal is dehusked and split legume). In addition to the GI, triglycéride (TG) responses of these foods were also determined. A higher GI was obtained for rice and for rice with peas; all other combinations yielded lower glycémie indices. However, all the foods produced significantly lower blood glucose response 2 hours postprandially as compared with blood glucose responses to a 50 g glucose load for the same group. No significant difference was observed for TG responses to the different foods.
INTRODUCTION Dietary modification is the most important part of the management of non-insulin-dependent diabetes mellitus (NIDDM), in which the primary derangement is of car bohydrate metabolism, with secondary abnormalities of lipid and protein metabolism. It has been found that the same weight of carbohydrate in different foods can produce widely different blood glucose responses. The concept of glycémie index (GI) was introduced as a physiological basis for carbohydrate exchange [1] and is important in determining glycémie responses of mixed meals versus individual foods. The nutrition committees of American and Canadian diabetes associations recom mend that diets for diabetics be planned with the GI of foods in mind [2,3]. Information regarding the GI of conventional Indian foods is scanty, except for foods evaluated by Dilawari et al [4] and Akhtar et al [5], who studied the glycémie responses to cereals and a few legumes and dais (dais are dehusked and split legumes). Hence, the present study was planned to determine the GI of six cereal-legume/dal combinations that are im portant in the diet of this region of India. Hyperglycemia brings about disturbances in lipid metabolism in diabetes and enhances secondary complications. Hence, foods recommended in diabetes should also have low lipemic
responses. In this study, we also report the postprandial triglycéride (TG) responses of the recipes along with postprandial sugar levels.
METHODS AND MATERIALS Thirty-six confirmed non-insulin-dependent diabetes mellitus (NIDDM) patients over 40 years of age on oral hypoglycémie drugs were selected for testing the glycémie response of the recipes. The clinical data for the subjects are given in Table 1. On the first visit, an oral glucose tolerance test (GTT) was done for all patients using 50 g glucose. Blood glucose was deter mined by the o-toluidine method [6] in fasting and postprandial (1- and 2-hr) samples; TG was determined in fasting and 2-hr postprandial blood samples [7]. The patients were divided into six groups, each group con sisting of six patients. On subsequent visits (within 2 weeks), the patients were given a test food containing 50 g carbohydrate which was consumed over 8-10 minutes. The composition of the foods as determined by food tables [8] is given in Table 2. Again, blood glucose and TGs were determined for the different groups fed different foods. GTT curves and glycémie response curves for the foods were plotted and GI was calculated
Addressreprintrequeststo Dr. Uliyar V. Mani, Department of Foods and Nutrition, MS University of Baroda, Baroda 390 002, Gujarat State, India
Journal of the American College of Nutrition, Vol. 9, No. 6, 573-577 (1990) © 1990 John Wiley & Sons, Inc.
CCC 0731-5724/90/060573-05$04.00
Glycémie Index of Various Meals Table 1. Clinical Data
Number of diabetic patients Mean age ± SD (years) Mean % ideal body weight ± SD (kg) Mean duration of disease ± SD (years)
Male
Female
17
19
52.8 ± 8.00
56.2 ± 6.50
12.21 ± 13.89
123.84 + 24.70
2.50 ±1.00
3.90 ± 0.60
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Table 2. Composition of Foods
Recipes Rice alone R,
Rice and legume R2
R3
R4
Food items
Botan ical name
Raw wt(g)
Energy Carbo Protein (kcal) hydrate (g) (g)
Fat (g)
Crude fiber (g)
Rice (milled, white rice)
Oryza sativa
64
221
50
4.4
0.3
0.13
Rice (milled) +Bengalgrama (chick peas) Rice (mUled) +Dried green peas" Rice (mUled) +Greengram (whole)3
Oryza sativa Cicer arietinum
45
155
35
3.1
0.2
0.089
25
90
15
4.3
1.3
0.98
Oryza sativa Pi sum sativum
45
155
35
3.1
0.2
0.089
27
85
15
5.3
0.3
1.21
Oryza sativa Phaseolus aureus
45
155
35
3.1
0.2
0.089
26
87
15
6.2
0.3
1.06
Oryza sativa Phaseolus aureus Oryza sativa Cajanus cajan
45
155
35
3.1
0.2
0.089
25
87
15
6.1
0.3
0.20
45
155
35
3.1
0.2
0.089
26
87
15
5.8
0.4
0.39
5
45
-
-
5.0
-
Rice and dal b Rs
Re
AU
Rice (milled) +Greengram dal Rice (milled) +Redgram dal (pigeon pea) Oil
a
The legumes were presoaked overnight for 12 hours and then cooked along with rice. Dal is dehusked and split legume.
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Table 3. Glycémie Index of the Foods Number Ri
R2 R3 R4 R5 *6
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a
Glycémie index (mean ± SE)
Recipe Rice (milled, white) Rice + Bengalgram (chick pea) Rice + peas (dried, green) Rice + greengram (whole) Rice + greengram dal Rice + redgram dal (pigeon pea)
74±8 a 54±lb 80 ±14 68 ±18 62 ± 8 64±6
' Significant at p < 0.05 level on comparison of a with b.
using the method described by Jenkins et al [1] by deter mining the ratio of the areas under the glucose response curve for the food, compared with that of the GTT. The TG response was calculated by finding the percent in crease in mean TG value over mean fasting value for six patients. The six foods given were: rice alone (R,); rice-Bengalgram (chick pea) (R2); rice-peas (dried green) (R3); rice-greengram (R4); rice-greengram dal (dehusked and split whole greengram) (R5); rice-redgram dal (dehusked and split whole pigeon pea) (R6). The foods were pres sure-cooked at 15 lb pressure for 15.5 minutes using 385 ml of water. The legumes (Bengalgram, peas, and greengram) were soaked overnight for 12 hours and then cooked with the rice. The glucose value after each test food and after the glucose load, was statistically compared using a paired t-test. Student's t-test for unpaired data was used to com pare glucose values among the test foods.
RESULTS The GI values obtained for the foods are given in Table 3. With the exception of R, and R2, there is no significant difference between mean GI values of the foods used. Table 4 presents the mean value ± SEM of blood glucose to a 50 g glucose load as well as the respective foods. There was a significantly lower blood glucose response after each of the foods at 2 hours postprandially when compared with the corresponding blood glucose response to the 50 g glucose load for the same group. One hour postprandially there were sig nificantly lower responses to R2, R3, R4, and R6 than to a 50 g glucose load for the same group, and the mean values of the remaining two foods were not significantly different from the response to glucose.
Table 5 presents the 2-hr postprandial TG response. No significant differences were observed for TG response among the foods.
DISCUSSION The concept of the GI of various foods has emerged as a boon to dietary therapy for diabetes mellitus, in dicating the beneficial aspect of foods consumed both individually and as mixed meals. Thus, GI results demonstrate differences in carbohydrate elevation of blood glucose levels, which is useful in planning diabetic diets. The differences observed in GI are attributable to the structure of starch granules, amylose and amylopectin content, protein and fat content, and the method of processing and preparation [9]. These observations have led to an analysis of foods consumed by populations of different countries for food habits and methods of preparation that vary greatly. Presented here is an exten sion of the studies by Dilawari et al [4] of glycémie responses to foods consumed in India and by Akhtar et al [5] of common Pakistani dishes. We have determined the GI for the most commonly used single foods and mixed meals in the region of Baroda (India) by determining glucose responses at two time intervals. Starch granules in cereal grains are structurally dif ferent from those in leguminous seeds. This affects par ticle size and surface area, resulting in altered digestion by hydrolytic enzymes. Rice starch granules are small and angular, probably resulting in a higher GI, as ob served for the GI of the foods tested in this study. Fur ther, the ratio of amylose to amylopectin content, as well as the amylopectin branching pattern, affects the physi cal characteristics of starch, both with regard to its cook ing quality and digestibility [10]. Legumes and dais have a higher amylose content (30-40%), which is more resis-
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Glycémie Index of Various Meals Table 4. Mean (+SE) Blood Glucose Responses (mg/dl) (n = 6) Postprandial responses
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Carbohydrate source
Fasting responses
1 hour
Glucose R[ — Rice alone
162 ± 12» 150±17 b
298 ± 23.03 260 ± 26.25
261 ±21.24 226 ± 20.44*
Glucose R2 — Rice + Bengalgram (chick pea)
169 ± 22» 152 ± 27b
329 ± 36 225 ± 30*
260 ± 32 189 ± 26*
Glucose R3 — Rice + dried green pea
140 ±25» 135 ± 24b
252 ±32 215 ± 29*
207 ± 37 183 ± 28*
Glucose R4 — Rice + greengram (whole)
148 ± 17» 125 ± 9 b
274 ±26 208 ± 34*
232 ± 21 170 ±23*
Glucose R5 — Rice + greengram dal
150 ±9» 137 ± 15b
282 ± 28 219 ±22
225 ± 21 179 ± 20*
Glucose R6 — Rice + redgram dal
194 ±21» 180±22 b
333 ± 28 271 ±25*
281 ±22 223 ± 22*
2 hours
♦Significantly lower response than glucose at p < 0.05. Nonsignificant on comparing a with b at p < 0.05.
Table 5. Mean (+SE) Triglycéride Responses (mg/dl) Fasting responses
2-hour postprandial responses
% increase over fasting
Glucose R, — Rice milled
132 ± 47 100 ±16
204 ±74 140 ± 18
40
Glucose R2 — Rice + Bengalgram (chick pea)
112 ±34 104 ±17
119 ±42 134 ± 22
28
Glucose R3 — Rice + dried green peas
97 ±36 104±21
107 ±44 125 ± 16
20
64 ±13 90 ±22
64 ±16 135 ±13
50
169 ± 25 152 ±15
221 ±46 164 ±40
8
62 ± 7 86 ± 8
79 ±18 120 ±13
39
Carbohydrate source
Glucose R4 — Rice + greengram (whole) Glucose R5 — Rice + greengram dal Glucose R6 — Rice + redgram dal (pigeon pea)
tant to cooking and digestion than amylopectin. Rice has a higher amylopectin content, which may partially ex plain the higher GI of rice. Dietary fiber, due to its viscous nature, inhibits starch digestion and/or absorption. Fiber and galactomannans that are present in legumes and dais (dehusked and split legume) are more viscous than those found in cereals [11]. The higher fiber content of legumes than of dais is responsible for their lower GI, as seen for R, and R2
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(p < 0.05). The differences among the foods tested sug gest that addition of Bengalgram (and possibly other legumes) to rice reduces the glycémie response. In spite of the fiber content being high in R3, the GI was found to be slightly higher than that of R,. This might be due to the higher glycémie response to peas, an observation ear lier recorded by Wolever et al [12] and Jenkins et al [13]. Besides dietary fiber, phytic acid lectins, saponins, tannins, and amylase inhibitors affect starch digestibility
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Glycémie Index of Various Meals and might be correlated negatively with glycémie response. Further experiments are required to determine the influence of such substances on the GI of foods. The method of cooking and preparation also affect starch digestion and hence glycémie response [14]. Cooking (gelatinization) disrupts the starch granule so that it is hydrolyzed in the intestine. In general, highamylose starch granules are less easily disrupted and are more slowly hydrolyzed by digestive enzymes. Thus, the higher GI of rice observed in this study may be attributed to its higher amylopectin content and possibly to over cooking with the heat in a pressure cooker [15]. The foods evaluated in this study were similarly prepared. Since diabetes meilitus causes not only abnormal car bohydrate metabolism but also alters lipid metabolism, especially cholesterol and TG [16,17], we also deter mined TG responses to the foods. The TG responses do not correlate with their fat content and were statistically nonsignificant. The TG responses did not correlate with GI responses. Further study with a larger sample size is necessary to verify these preliminary findings. For NIDDM patients, foods that evoke low TG responses may have value in the dietary management of diabetes meilitus. Since several factors in foods affect glycémie and TG responses, prediction of response on the basis of chemi cal analysis is difficult. Hence, much research is required to evaluate the relative merits of classifying foods ac cording to GI versus the exchange system used at present in planning diabetic diets.
ACKNOWLEDGMENTS The authors express their grateful thanks to Professor D. J. A. Jenkins and Professor T. M. S. Wolever of the Department of Nutritional Sciences at the University of Toronto (Canada) for their valuable criticisms and sug gestions in the preparation of this manuscript.
REFERENCES 1. Jenkins DJA, Wolever TMS, Taylor RH: Glycémie index of foods: a physiological basis of carbohydrate exchange. Am J Clin Nutr 34:362-367, 1981.
2. American Diabetes Association: Policy statement: glycémie effects of carbohydrate. Diabetes Care 7:607608, 1984. 3. Special Report Committee, Canadian Diabetes Associa tion: Guidelines for the nutritional management of Diabetes Meilitus. J Can Diet Assoc 42:110-118,1981. 4. Dilawari JB, Kamat PS, Batta RP, Mukewar S, Raghavan S: Reduction of postprandial plasma glucose by Ben galgram dal (Cicer arietinum) and Rajmah (Phaseolus vulgaris). Am J Clin Nutr 34:2450-2353, 1981. 5. Akhtar MS, Asim AH, Wolever TMS: Blood glucose responses to traditional Pakistani dishes taken by normal and diabetic subjects. Nutr Res 7:696-706, 1987. 6. Council for Scientific and Industrial Research: Diagnostic kit for blood glucose, method of Hultman E. Nature (Lon don) 183:108-109, 1959. 7. Foster LB, Dunn RJ: Stable reagent for determination of serum triglycérides by a calorimetrie Hantzsh condensa tion method. Clin Chem 19:338-340, 1973. 8. Gopalan C, Ramashastri BV, Balasubramaniam SC: Proximate principles, minerals, and vitamins. In National Institute of Nutrition (ed): "Nutritive Values of Foods." Hyderabad: Citizen Press, pp 60-115, 1979. 9. Jenkins DJA, Jenkins AL, Wolever TMS: Simple and complex carbohydrates. Nutr Rev 44(2):44-48, 1986. 10. Behall KM, Scholfield DJ, Canary J: Effect of starch structure on glucose and insulin responses in adults. Am J Clin Nutr 47:428-432, 1988. 11. Jenkins DJA, Wolever TMS, Leeds AR: Dietary fibres, fibre analogues and glucose tolerance: importance of vis cosity. Br Med J 1:392-394,1978. 12. Wolever TMS, Csima A, Jenkins DJA, Wong GS, Josse RG: The glycémie index: variation between subjects and predictive difference. J Am Coll Nutr 8:235-247, 1989. 13. Jenkins DJA, Wolever TMS, Taylor RH, Barker HM, Fielden H: Exceptionally low blood glucoseresponsesto dried beans: comparison with other carbohydrate foods. Br Med J 281:578-580, 1980. 14. Gannon MC, Nuttall FQ: Factors affecting interpretation of postprandial glucose and insulin areas. Diabetes Care 10:759-763, 1987. 15. Krezowski DA, Nuttall FQ, Gannon MC: Insulin and glucose responses to various starch-containing foods in type II diabetic subjects. Diabetes Care 10:205-211,1987. 16. Cerami A, Vlassara H, Brownlee M: Glucose and aging. Sei Am 256:90-97,1987. 17. Reaven GM: Abnormal lipoprotein metabolism in non-in sulin-dependent diabetes meilitus: pathogenesis and treat ment. Am J Med 83:31-39, 1987. ReceivedNovember 1988; revision accepted April 1990.
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